Say it ain’t so

If you follow this blog’s Facebook page, you probably saw the little blurb I put up over the weekend. I photographed part of a page out of Diabetes Forecast, the magazine published by the American Diabetes Association. As I see it, this is a respectable organization; there are no lies, ulterior motives, or deep discounts on snake oil from them. If they say it, I tend to believe it.

But in September’s issue, right there on page 20, was the bold headline that you see above. The paragraph that follows was quite disturbing, and generated a bit of discussion under the Facebook post.

The online version of the story, with the same content but a headline slightly modified to read “INACTIVE KIDS HAVE HIGHER TYPE 1 RISK” is available for all to read — if you dare. With respect to the magazine’s copyright, I won’t copy the entire piece here, but the first sentence just about sums it up:

“Kids at high risk for developing type 1 diabetes exercise less and sit around more than those at lower risk, a study found.”

Umm, yeah.

That is the very myth that we’ve been trying to bust. And we vow to continue tearing down that misconception every day. Forever and ever, amen.

We’ve know of athletic kids who’ve developed Type 1. We’ve seen inactive kids escape it. Kids who are too young even to walk get diagnosed. Then there are adults, teens, parents, athletes, and so on. T1D doesn’t discriminate.

But it was reported by the American Diabetes Association, and they cite a seemingly legitimate (albeit limited in scope) study. So it has to be true, right?

When I first read this piece, I didn’t immediately dismiss it as, to borrow a term from one of the Facebook comments, bullhonkey. My first thought was “Holy crap. You mean the stupid, ignorant ones were right and we were wrong? How can we show our faces in public again?” I mean, consider the source.

Sure, the study is based on an average. And one exceptional case can skew an average to the point where it no longer represents the group it claims to depict. I don’t know where to find information on this study (and I don’t know if I’d understand it if I did find it), but I’d rather see a Trident-like “four-out-of-five” statement than an average. I wonder if that information is available.

“Facts are meaningless.
You could use facts to prove anything that’s even remotely true!”

–Homer Simpson

In other words, data can be presented honestly, but manipulated to tell a completely dishonest story.

Is this story dishonest? I don’t know. I don’t want to lose faith in an organization that I trust, but at the same time I’m ready to start my toddler with a three- mile run on the treadmill every day if it will help to keep the big-D away.

Yes, I know Forecast is just the messenger, but I wish there were some more thought put behind the choice to deliver it.

“The researchers tracked the physical activity of 62 autoantibody-positive children and 50 study participants without autoantibodies. The kids with autoantibodies exercised an average of 70 minutes less and were inactive for 110 minutes per week more than those with no autoantibodies”

This doesn’t indicate that active kids are at lower risk – all this tells me is that kids who have autoabtibodies, for some reason or another, exercise less than kids who don’t. Why? Who knows, but I’d like to see if this research included accounting for bias such as demographic differences.

Show me a study where they take autoantibody-negative kids, track them for physical activity, stratify for demographics, and then prove that inactivity increases the odds of a child turning from negative-to-positive. Now THAT would be diabetes-forecast worthy.

And hey – did you know that people who drink coffee in the morning are more likely to get into a car accident than those who don’t drink coffee in the morning? We know this because after interviewing 100 people who got into a car accident on their morning commute, 80% of them admitted to drinking coffee. Same strange phenomenon amongst orange juice drinkers and toast eaters.

I’m in the “gggrrrr” family of responders here. A mere 102 participants in a study, and they make this statement as if it’s fact? I was a psychology major in college. You wouldn’t believe some of the studies we came up with, and we could make anything come out as true as long as we had a small enough and targeted sample size. (Homer is wise in that regard. Scary.)

I saw this on your FB page this weekend and hurt my eyes because they were rolling in the back of my head. Too small of a group. Too sweeping of a statement. And like most others I know who were diagnosed as kids, I was very active. In fact, when I was in the throes of pre-diagnosis but knowing that something was wrong, I was still dancing 3 hours a week in the studio. (Yes, I was peeing every five minutes, so maybe it wasn’t a full three hours…)
And I like bullhonkey. That may become part of my lexicon.

You’re right that there will always be exceptions to the rule — people who don’t fit the so-called profile. . But I do feel like I’m finding more exceptions than followers, which does cause me to raise an eyebrow or two.

Meanwhile, a year ago I would have said (actually, I *did* say to my wife) that my getting diabetes was a total fluke and that there are no external, environmental triggers. But as I’ve gotten more in tune to the research, I do believe that there is some external force at work, I just don’t know what it is. (and I’m not ready to tell her that I was wrong, either).

Grrr….I used to subscribe to Diabetes Forecast but always felt it was geared more towards T2Ds not T1 so I let my subscription expire (is there any magazine for T1s!?). I guess this article will be another reason I’m glad I don’t subscribe anymore.

I love this statement you wrote: “Yes, I know Forecast is just the messenger, but I wish there were some more thought put behind the choice to deliver it.” Seriously, who ever decided to publish the study had to of known there would be a lot of backlash from the T1 community…either that or they don’t know ANYTHING about the T1 community-so sad :-(

In fairness, the current editor of the magazine is a T1D herself — and an active one in the DOC too (I always see her participating in the Wednesday DSMA chats). I think she’s done a great job at giving the magazine more parity between the two types. I hesitate to even bring this post up because I highly respect Ms. Rawlings and don’t wish to upset her, but I couldn’t let this article pass by either.

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